Treatment of adult obesity
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As rates of obesity have increased this disease has become a common problem that physicians are faced with treating. This paper aims to review the different options for patients and determine the best treatments for obesity. Modalities that are considered include dietary treatment, exercise, pharmacologic treatment, and weight loss surgery. This study compares reduced calorie diets, low fat diets, low glycemic index/load diets, the Mediterranean diet, and low carbohydrate diets. The validity of exercise as an effective prescription for obesity is evaluated and debunked. Pharmacologic treatments that are contrasted include those drug therapies that are currently approved by the United States Food and Drug Administration for the long-term treatment of obesity. Those are orlistat, lorcaserin and phentermine/topiramate. The surgical treatments reviewed include vertical banded gastroplasty, adjustable gastric banding, Roux-en Y gastric bypass, biliopancreatic diversion, and biliopancreatic diversion with duodenal switch. After a comprehensive review of the literature the conclusion reached was that treatment for obesity should begin with the least invasive options and those that have the least potential for harm. That is, diet should be a first course of action. Among diets a Mediterranean diet or another culturally adapted low glycemic index/load diet is best. However, more studies are needed to determine how to translate the diets for different cultures and individual tastes. When diets are unable to produce enough weight loss, pharmacologic treatments are considered. Among them, lorcaserin and phentermine/topiramate do not have enough long-term studies to warrant a strong recommendation as of the publishing of this paper. The only other option available, orlistat, comes with many uncomfortable gastrointestinal side effects, so it is also not an ideal option. In addition, orlistat does not produce the amount of weight loss that is seen with surgical procedures. Patients and physicians considering surgical treatment for obesity will find that the best option is laparoscopic adjustable gastric banding.